NACCHO announced the availability of the 2014 Forces of Change survey. The survey provides new findings on the forces that affect change in our nation’s local health departments, including economic forces, health reform, and health department accreditation. Many local health departments continue to experience budget cuts and job losses. Most local health departments are increasingly billing public and private third-party payers for clinical services. Some have played a role in helping community members enroll in health insurance programs. More have been formally pursing accreditation through the Public Health Accreditation Board. To access the five issue briefs, please visit www.naccho.org/topics/research/forcesofchange.